Pseudofolliculitis of the Beard Follow-up

  • Author: Thomas G Greidanus, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jan 17, 2012
 

Further Outpatient Care

  • Outpatient evaluation and patient education is effective. With proper techniques, transfollicular and extrafollicular penetration can be minimized.
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Deterrence/Prevention

  • Hair-releasing procedures and shaving should be performed after a shower to hydrate and soften both the skin and the hair. Subsequent shaving results in a duller, rounded tip to the hair, which is less likely to reenter the skin.
  • Wash the beard with a face cloth, a wet sponge, or a soft-bristled toothbrush with a mild soap for several minutes using a circular motion. This technique helps to dislodge stubborn tips.
  • Using needles or toothpicks to dislodge stubborn tips is controversial. It usually is not recommended because overly aggressive digging with sharp objects can cause further damage to the skin.
  • Patients with pseudofolliculitis barbae may use razors if single-edged, foil-guarded, safety razors are used.[19] Double- or triple-bladed razors shave too closely and should not be used. Commercially available foil-guarded razors have about 30% of the blade covered by foil, which prevents the blade from shaving the hair too closely.
  • Electric razors have acceptable results if used properly. The recommended technique with a 3-headed rotary electric razor is to keep the heads slightly off the surface of the skin and to shave in a slow, circular motion. Do not press the electric razor close to the skin or pull the skin taut because this results in too close of a shave. Some electric razors have "dial in" settings for the closeness of the shave. These may be effective if kept off of the closest settings.
  • Electric clippers are effective for resistant cases of pseudofolliculitis barbae. With clippers, 1- to 2-mm stubble can be left on the face. The tendency to shave too closely is reduced with this method, making it more effective. The appearance of stubble may be cosmetically unacceptable for some patients.
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Complications

  • Although usually not regarded as a serious medical problem, pseudofolliculitis barbae may cause cosmetic disfigurement. The papules may lead to scarring, postinflammatory hyperpigmentation, secondary infection, and keloid formation.
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Prognosis

  • No cure exists, but effective treatment is available. If the patient is able to grow a beard, the problem usually disappears (except for any residual scarring).
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Patient Education

  • Instruct the patient to stop shaving for 3-4 weeks. This gives adequate time for the hair follicles to grow to a length where ingrown hairs will spring free.
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Contributor Information and Disclosures
Author

Thomas G Greidanus, MD  Chair, Department of Emergency Medicine, Parkview Medical Center

Disclosure: Nothing to disclose.

Coauthor(s)

Beth Honl, MD  Dermatology Associates, PC; Private Practice

Beth Honl, MD is a member of the following medical societies: American Academy of Dermatology and American Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Leonard Sperling, MD  Chair, Professor, Department of Dermatology, Uniformed Services University of the Health Sciences

Leonard Sperling, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Richard P Vinson, MD  Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Jeffrey Meffert, MD  Assistant Clinical Professor of Dermatology, University of Texas School of Medicine at San Antonio

Jeffrey Meffert, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Association of Military Dermatologists, and Texas Dermatological Society

Disclosure: Nothing to disclose.

Joel M Gelfand, MD, MSCE  Medical Director, Clinical Studies Unit, Assistant Professor, Department of Dermatology, Associate Scholar, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania

Joel M Gelfand, MD, MSCE is a member of the following medical societies: Society for Investigative Dermatology

Disclosure: AMGEN Consulting fee Consulting; AMGEN Grant/research funds Investigator; Genentech Grant/research funds investigator; Centocor Consulting fee Consulting; Abbott Grant/research funds investigator; Abbott Consulting fee Consulting; Novartis investigator; Pfizer Grant/research funds investigator; Celgene Consulting fee DMC Chair; NIAMS and NHLBI Grant/research funds investigator

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

  1. Crutchfield CE 3rd. The causes and treatment of pseudofolliculitis barbae. Cutis. Jun 1998;61(6):351-6. [Medline].

  2. Quarles FN, Brody H, Johnson BA, et al. Pseudofolliculitis barbae. Dermatol Ther. May-Jun 2007;20(3):133-6. [Medline].

  3. Kindred C, Oresajo CO, Yatskayer M, Halder RM. Comparative evaluation of men's depilatory composition versus razor in black men. Cutis. Aug 2011;88(2):98-103. [Medline].

  4. Garcia-Zuazaga J. Pseudofolliculitis barbae: review and update on new treatment modalities. Mil Med. Jul 2003;168(7):561-4. [Medline].

  5. Olsen EA. Methods of hair removal. J Am Acad Dermatol. Feb 1999;40(2 Pt 1):143-55; quiz 156-7. [Medline].

  6. Childs ND. Tretinoin, hydrocortisone cream controls PFB. Skin and Allergy News. 1999;30(5):20.

  7. Kligman AM, Mills OH Jr. Pseudofolliculitis of the beard and topically applied tretinoin. Arch Dermatol. Apr 1973;107(4):551-2. [Medline].

  8. Taylor S. Open-Label Case Study on Triple-Combination Cream in Patients with Pseudofolliculitis Barbae. J Am Acad Dermatol. 2005;52:P169.

  9. Brown LA Jr. Pathogenesis and treatment of pseudofolliculitis barbae. Cutis. Oct 1983;32(4):373-5. [Medline].

  10. Leyden JJ. Topical treatment for the inflamed lesion in acne, rosacea, and pseudofolliculitis barbae. Cutis. Jun 2004;73(6 Suppl):4-5. [Medline].

  11. Callender V, Young CM. Combination Laser and Eflornithine HCL 13.9% Cream: A First-line Therapy for Fitzpatrick Type IV-VI Patients With Excessive Facial Hair. J Am Acad Dermatol. Mar 2005;52(3) suppl:P209.

  12. Chuh A, Zawar V. Epiluminescence dermatoscopy enhanced patient compliance and achieved treatment success in pseudofolliculitis barbae. Australas J Dermatol. Feb 2006;47(1):60-2. [Medline].

  13. Bridgeman-Shah S. The medical and surgical therapy of pseudofolliculitis barbae. Dermatol Ther. 2004;17(2):158-63. [Medline].

  14. Kauvar AN. Treatment of pseudofolliculitis with a pulsed infrared laser. Arch Dermatol. Nov 2000;136(11):1343-6. [Medline].

  15. Perry PK, Cook-Bolden FE, Rahman Z, Jones E, Taylor SC. Defining pseudofolliculitis barbae in 2001: a review of the literature and current trends. J Am Acad Dermatol. Feb 2002;46(2 Suppl Understanding):S113-9. [Medline].

  16. Robins P, Battle EF Jr, Alexis AF, Cook-Bolden F, Alqubaisy Y, McLeod MP, et al. Unique laser techniques in patients with skin of color. J Drugs Dermatol. Dec 1 2011;10(12):4-26. [Medline].

  17. Schulze R, Meehan KJ, Lopez A, et al. Low-fluence 1,064-nm laser hair reduction for pseudofolliculitis barbae in skin types IV, V, and VI. Dermatol Surg. Jan 2009;35(1):98-107. [Medline].

  18. Ross EV, Cooke LM, Timko AL, Overstreet KA, Graham BS, Barnette DJ. Treatment of pseudofolliculitis barbae in skin types IV, V, and VI with a long-pulsed neodymium:yttrium aluminum garnet laser. J Am Acad Dermatol. Aug 2002;47(2):263-70. [Medline].

  19. Alexander AM. Evaluation of a foil-guarded shaver in the management of pseudofolliculitis barbae. Cutis. May 1981;27(5):534-7, 540-2. [Medline].

  20. Alexander AM, Delph WI. Pseudofolliculitis barbae in the military. A medical, administrative and social problem. J Natl Med Assoc. Nov 1974;66(6):459-64, 479. [Medline].

  21. Brauner GJ, Flandermeyer KL. Pseudofolliculitis barbae. Medical consequences of interracial friction in the US Army. Cutis. Jan 1979;23(1):61-6. [Medline].

  22. Coquilla BH, Lewis CW. Management of pseudofolliculitis barbae. Mil Med. May 1995;160(5):263-9. [Medline].

  23. Galaznik JG. A Pseudofolliculitis Barbae clinic for the black male who has to shave. J Am Coll Health. Dec 1984;33(3):126-7. [Medline].

  24. Halder RM. Pseudofolliculitis barbae and related disorders. Dermatol Clin. Jul 1988;6(3):407-12. [Medline].

  25. Nidecke A. Saving face: help black men avoid pseudofollicultis barbae. Skin and Allergy News. 1998;29 (10):46.

  26. Scheinfeld NS. Pseudofolliculitis barbae. Skinmed. May-Jun 2004;3(3):165-6. [Medline].

 
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Pseudofolliculitis barbae on the neck of a black man.
 
 
 
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